| NPI | 1285894071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: VA 0101252198) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 0101252198) |
| 207R00000X Internal Medicine (Licence: VA 0101252198) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT196434) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0116019374) | |
| Enumeration Date | 2008-06-15 |
| Last Update Date | 2021-09-02 |